Poverty-Based Sliding Fee Plans

1. Display the Poverty-Based Sliding Fee Plans page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Fee and Allowable Schedules, click Sliding Fee Plans (Poverty-Based).
2. Effective Dates for Poverty Guidelines — Federal poverty guidelines are published every year by the Department of Health and Human Services (HHS). HHS decides their effective start date. You can change when they take effect in your practice by setting a custom start date, if needed.
   • Set custom start date — Select the effective start date for your practice. Read the information about how the date is used, check the acknowledgment box, then click Save.
3. Locate the poverty-based sliding fee progam in the table and click add or edit. (You see the add option if you are adding the first sliding fee plan to the program.)
   The Edit Poverty-Based Sliding Fee Plans view appears.
   
4. Click to add a plan to the poverty-based sliding fee program.
5. Poverty level range — Enter the lower income bound in the From field, and enter the upper income bound in the Up to field.
   The set of plans contained in a program should have poverty level ranges that do not overlap or leave gaps. You can leave one end of the range blank. For example, if you want to create two poverty-based plans, you can set the poverty level ranges as follows:
• For one plan, leave the first value blank and set the second value to 99% to include patients with income below the current poverty rate.
• For the second plan, set the values to 100% and 120% to include patients with income from 100% to 120% of the current poverty rate.
  
6. Plan name — Enter a descriptive name for your plan.
7. Calculation type — Select the appropriate calculation type:
• Flat fee only — Select this option if the patient responsibility is a flat fee.
• Percentage only — Select this option if the patient responsibility is a percentage of charges.
• Flat fee + percentage of the remaining balance — Select this option if the patient responsibility includes both a flat fee and a percentage of charges remaining after the flat fee.
• Percentage of total charge + additional flat fee — Select this option if the patient responsibility is a percentage of total charges plus an additional flat fee.
• Lesser of flat fee and percentage — Select this option if the patient responsibility is the lesser of a flat fee or a percentage.
• Greater of flat fee and percentage — Select this option if the patient responsibility is the greater of a flat fee or a percentage.
8. Flat fee — Enter the flat fee responsibility amount in dollars. athenaOne automatically requires or disables this field, based on the calculation type selected.
9. Patient responsibility — Enter the percentage of charges that the patient is responsible for. athenaOne automatically requires or disables this field, based on the calculation type selected.
10. Custom transaction code — Select a custom transaction code (optional).
    Note: Custom transaction codes are used to differentiate between two collections agencies, or between free care for professional courtesy and free care in conjunction with a local charity. Custom transaction codes are administered via the Custom Transaction Codes page.
11. Transaction reason — Select a transaction reason (optional).
12. Note — Enter any notes (optional).
13. Click to add another poverty-based plan, or click Save all.

On the Poverty-Based Sliding Fee Plans page:

(Note: These links only appears if you already have a custom start date.)

• Change custom start date — Select a different start date. Read the information about how the date is used, check the acknowledgment box, then click Save.
• Switch to HHS start date — Read the information about the impact of switching to the HHS start date, check the acknowledgment box, then click Save.

1. Display the Poverty-Based Sliding Fee Plans page: On the Main Menu, click Settings > Billing. In the left menu, under Practice Links — Fee and Allowable Schedules, click Sliding Fee Plans (Poverty-Based).
   
2. Locate the poverty-based sliding fee progam in the table and click poverty level table.
   The Poverty Ranges for Sliding Fee Program window opens.
   

1. Display the patient's Quickview page.
2. Scroll down to the Insurances area and click add new.
   The Add Policy page appears with the Policy Lookup tab selected by default.
3. Click the Self-Pay tab, or click Self Pay in the Favorites list.
4. Click Select next to Sliding Fee Schedule - Discount.
   The Add Cash Policy Details page appears.
5. Sliding fee program — Select a poverty-based sliding fee program from the menu.
   Additional fields appear.
6. Family size — Enter the number of people in the patient's family.
7. Income — Enter the family's income as a whole dollar amount (without a dollar sign or commas), and select the time frame for the income.
   Note: athenaOne converts the income to an annual amount before it performs a lookup in the HHS Poverty Guidelines table.
8. Click Calculate plan to the right of the Income field.
   The sliding fee plan is displayed.
   Note: When you select a poverty-based sliding fee plan, athenaOne calculates the correct plan according to the most recently uploaded HHS Poverty Guidelines. athenaOne continues to use the selected plan for the patient until someone selects a new plan, the plan is deactivated, or the expiration date is reached.
9. Effective date — Enter or select the effective date for the sliding fee plan.
   Leave this field blank to make the policy effective immediately, until you delete or modify it.
   
10. Expiration date — Enter or select the expiration date (if available).
11. Notes — Enter any notes about the plan and the patient.
    
12. Click Add Cash Plan.

1. Display the patient's Quickview page: In the text box at the top right of the Main Menu, enter the first three letters of the patient's last name, followed by a comma, followed by the first three letters of the patient's first name. Click the search icon. On the Find a Patient page, click Quickview for the patient you need.
2. Cash — Click Update this cash plan.
   The Update Cash Policy Details page appears. For security reasons, asterisks appear in the Family size and Income fields.
   
3. Family size — Click edit.
   Note: For security reasons, the amounts you previously entered in the Family size and Income fields do not appear. To view these amounts, you must create a custom report.
4. Enter new data in each field, as necessary.
5. Click Update Cash Plan.

You can attach scanned documents, such as application packets, financial aid paperwork, and required proof-of-income documentation, to a sliding fee plan.

Note: We encourage you to remove sensitive information, such as Social Security numbers and employee ID numbers, from the scanned document before you attach it to a sliding fee plan.

1. Display the patient's Quickview or Check-in page.
2. Under the Insurances heading, locate the patient's sliding fee plan.
3. Click Add/update documentation under the sliding fee plan information.
4. Click Choose File.
5. Locate the scanned file and select it.
   You can attach a .tif, .jpg, .bmp, .gif, .png, .dcm, or .pdf file; the maximum file size is 50 MB.
6. Click Add Document.